Lung incarceration after anterior mediastinal tracheostomy.

Abstract

A 63-year-old man underwent anterior mediastinal tracheostomy for postradiotherapy stoma ulceration exposing the left anterolateral tracheal side, cervical vessels, and pharynx. An anterior chest wall defect (hemiclaviculectomy, manubriectomy, and resection of anterior third of first and second ribs bilaterally) was covered by a myocutaneous pectoral flap, and a new tracheostoma was constructed in the middle of the skin island. At postoperative day 7, a protrusion of the right upper lobe outside the thoracic cavity through the anterior chest wall defect was detected. Surgical repair by a right thoracotomy to reposition the lung and defect repair using an expanded polytetrafluoroethylene (Gore-Tex) internal prosthesis were successful. The patient was discharged home at 63 days after the first operation.